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Coronary Artery Calcium Score: the “Mammogram” of the Heart?

  • Public Health Policy (E Klodas, Section Editor)
  • Published:
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Abstract

Purpose of Review

To discuss the classic analogy of “coronary artery calcium (CAC) as a mammogram of the heart”, by evaluating the conceptual strengths, weaknesses, opportunities, and threats of a potential cardiovascular disease (CVD) screening strategy using CAC in apparently healthy adults.

Recent Findings

CAC is typically used for further CVD risk assessment. CAC is also currently being used as a screening test in specific subgroups of individuals, particularly in some Asian countries. Although this has yielded valuable insights on the determinants and pathophysiology of CVD, whether this approach results in improved clinical outcomes compared to other assessment and management approaches is currently unclear.

Summary

Although CAC and mammograms share a number of characteristics, there are also important conceptual differences. The evidence supporting CAC, which is a robust CVD risk assessment tool, for CVD screening purposes is currently very limited, and further research is needed.

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Author information

Authors and Affiliations

  1. Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, MD, USA

    Miguel Cainzos-Achirica, Catherine E. Handy, Renato Quispe, Roger S. Blumenthal & Michael J. Blaha

  2. Department of Cardiology, Bellvitge University Hospital and Bellvitge Biomedical Research Institute (IDIBELL), 19th Floor, Feixa Llarga s/n, 08907 L’Hospitalet de Llobregat, Barcelona, Spain

    Miguel Cainzos-Achirica, Gerard Roura & Josep Comin-Colet

  3. School of Medicine and Medical Sciences, Universitat Internacional de Catalunya, Barcelona, Spain

    Miguel Cainzos-Achirica

  4. RTI Health Solutions, Pharmacoepidemiology and Risk Management, Barcelona, Spain

    Miguel Cainzos-Achirica

  5. Breast Imaging Division, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD, USA

    Philip A. Di Carlo

  6. Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Medical Institutions, Baltimore, MD, USA

    Catherine E. Handy

  7. Cardiovascular Risk Unit, Department of Internal Medicine, Bellvitge University Hospital, 7th Floor, Feixa Llarga s/n, 08907 L’Hospitalet de Llobregat, Barcelona, Spain

    Xavier Pinto & Xavier Corbella

  8. Department of Clinical Sciences, Universitat de Barcelona, Barcelona, Spain

    Josep Comin-Colet

  9. Department of Internal Medicine, Bellvitge University Hospital and Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain

    Xavier Corbella

  10. Hestia Chair in Integrated Health and Social Care, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain

    Xavier Corbella

  11. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA

    Michael J. Blaha

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  1. Miguel Cainzos-Achirica
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  2. Philip A. Di Carlo
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  3. Catherine E. Handy
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  4. Renato Quispe
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  5. Gerard Roura
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  6. Xavier Pinto
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  7. Roger S. Blumenthal
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  8. Josep Comin-Colet
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  9. Xavier Corbella
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  10. Michael J. Blaha
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Correspondence to Miguel Cainzos-Achirica.

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Conflict of Interest

Miguel Cainzos-Achirica reports that he collaborates with RTI Health Solutions, an independent nonprofit research organization that does work for government agencies and pharmaceutical companies.

Catherine E. Handy reports grants from Conquer Cancer Foundation/Bristol Meyers Squibb.

Xavier Pinto reports grants from FIS-ISCIII and CIBER-ISCIII and personal fees from Amgen, Abbott, Sanofi, Lacer, Rubio, and Esteve.

Michael J. Blaha reports grants from NIH, FDA, AHA, and Aetna Foundation; grants and personal fees from Amgen Foundation; and personal fees from Novartis, Sanofi/Regeneron, MedImmune, and Akcea.

Philip A. Di Carlo, Renato Quispe, Gerard Roura, Roger S. Blumentha, Josep Comin-Colet, and Xavier Corbella declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Cainzos-Achirica, M., Di Carlo, P.A., Handy, C.E. et al. Coronary Artery Calcium Score: the “Mammogram” of the Heart?. Curr Cardiol Rep 20, 70 (2018). https://doi.org/10.1007/s11886-018-1020-9

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